title: Intermediate-term outcomes of robot-assisted laparoscopic nephroureterectomy in upper urinary tract urothelial carcinoma.
abstract: BACKGROUND
  The purpose of this study was to evaluate the intermediate-term oncological outcomes after (RAL-NU) for UUT-UC.
  
  
  METHODS
  Between May 2007 and December 2010, 32 patients with UUT-UC underwent RAL-NU. Data were obtained from a prospectively maintained database.
  
  
  RESULTS
  Median patient age was 66.5 years. Final pathological stage was pathologic stage Ta (pTa) in 12.5% (n = 4) of patients, pT1 in 28.1% (n = 9), pT2 in 18.8% (n = 6), pT3 in 40.6% (n = 13), and pT4 in 0%. High-grade lesions were present in 81.2% (n = 26) of patients and multifocal disease was present in 25.0% (n = 8). Positive surgical margins occurred in 1 patient. Median follow-up was 45.5 months (range, 24-65). At 2 and 5 years, overall survival was 81.3% and 60.9%; cancer-specific survival was 87.3% and 75.8%, and nonurothelial recurrence-free survival was 71.5% and 68.1%, respectively. On univariate analysis, female sex, positive surgical margins, and pathological tumor stage pT2 and higher are associated with reduced recurrence-free survival (P = .035 and .011, respectively). On multivariate analysis, only female sex and pathological stage pT2 or higher were significant factors (P = .020 and .049, respectively). No factors were found to affect cancer-specific survival.
  
  
  CONCLUSIONS
  To our knowledge, this represents the largest and longest follow-up after RAL-NU to date. Intermediate-term oncological outcomes seem comparable with those of open and laparoscopic nephroureterectomy. We recommend further larger studies with longer follow-up periods to further define the role of RAL-NU in the treatment of UUT-UC.
authors.affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Sey Kiat
authors.initials: SK
authors.lastname: Lim
authors.forename: Tae-Young
authors.initials: TY
authors.lastname: Shin
authors.forename: Kwang Hyun
authors.initials: KH
authors.lastname: Kim
authors.forename: Byung Ha
authors.initials: BH
authors.lastname: Chung
authors.forename: Sung Joon
authors.initials: SJ
authors.lastname: Hong
authors.forename: Young Deuk
authors.initials: YD
authors.lastname: Choi
authors.forename: Koon Ho
authors.initials: KH
authors.lastname: Rha
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007668:Kidney / Q000601:surgery; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012371:Robotics / Q000379:methods*; D012737:Sex Factors; D013534:Survival; D015996:Survival Rate; D016896:Treatment Outcome; D014551:Urinary Tract / Q000473:pathology / Q000601:surgery*; D014571:Urologic Neoplasms / Q000473:pathology / Q000601:surgery*; D019459:Urothelium / Q000473:pathology / Q000601:surgery*
keywords: Oncological outcomes; Overall survival; Recurrence; TCC ureter; Transitional cell